Ileus primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

Effective measures for the primary prevention of ileus include early mobilization, avoidance of Ryle's tube (nasogastric tube), prior oral feeding with high carbohydrate solid or liquid solution, limiting parenteral fluids, avoidance of pain medications such as opiates, utilizing a minimally invasive surgical method and use of epidural anesthesia for postoperative analgesia.

Effective measures for the primary prevention of ileus include:^[1]^[2]^[3]^[4]

Early mobilization
Avoid routine insertion of Ryle's tube (nasogastric tube)
Prior oral feeding with high carbohydrate solid or liquid solution (preferably six hours prior to surgery)
Administration of clear fluids within 2-3 hours of surgery
Limited parenteral fluids
Utilizing a minimally invasive surgical method if possible
Avoidance of pain medications such as opiates
Epidural catheter (spinal anesthesia) for postoperative analgesia
Postoperative gum chewing, which may increases the intestinal peristalsis due to the cephalovagal reflex and inflammation (level Ia evidence)

↑ Resnick J, Greenwald DA, Brandt LJ (1997). "Delayed gastric emptying and postoperative ileus after nongastric abdominal surgery: PART I". Am. J. Gastroenterol. 92 (5): 751–62. PMID 9149181.
↑ Resnick J, Greenwald DA, Brandt LJ (1997). "Delayed gastric emptying and postoperative ileus after nongastric abdominal surgery: PART II". Am. J. Gastroenterol. 92 (6): 934–40. PMID 9177505.
↑ Patel, Santosh; Panchagnula, Umakanth; Lutz, JanM; Bansal, Sujesh (2012). "Anesthesia and perioperative management of colorectal surgical patients - A clinical review (Part 1)". Journal of Anaesthesiology Clinical Pharmacology. 28 (2): 162. doi:10.4103/0970-9185.94831. ISSN 0970-9185.
↑ Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC (2017). "Ileus in Adults". Dtsch Arztebl Int. 114 (29–30): 508–518. doi:10.3238/arztebl.2017.0508. PMC 5569564. PMID 28818187.